(1) Background: Patella and achilles tendon injuries have become increasingly prevalent due to an increasingly active population. These injuries can cause significant dysfunction which is especially true for elite athletes. Standard B-Mode ultrasound has been useful in the diagnosis of these injuries, however, only to a limited extent. Shear wave elastography (SWE) can aid in evaluation by objectively measuring tissue stiffness. Prior studies have proven shear wave values can be used to evaluate tendon tissue noting differences in healthy versus pathologic tendons. One main limitation remains a lack of normative data for specific tendon tissues which we aim to address in this study; (2) Methods: A cross-sectional study of healthy volunteers aged 18-65 without lower extremity injury was evaluated using A Samsung RS85 Prestige ultrasound machine with a 14L-2 MHz transducer. Shear wave values were collected in a standardized manner for the patellar tendon at one location, as well as the achilles tendon at the midportion and insertional areas; (3) Results: Data for 54 healthy adult patellar and achilles tendons was collected bilaterally. The mean SWE average of the patellar tendon (P1-P3) for all subjects was 96.3 +/- 10.9 kPA. A higher BMI was correlated with a decrease in patella tendon kPA and the mean PT1 was higher for males compared to females (adjusted mean 96.4 kPA for males and 88.5 kPA for females, mean difference = 7.9 kPA; P = 0.009). The mean SWE average of the insertional Achilles (AT1-AT3) for all subjects was 101.7 +/-16.2 kPA and for the midportion achilles (MTP1-MTP5) was 145.6 +/- 18.8 kPA. There was a decrease in kPA for insertional Achilles measurements in those with a higher BMI, but this did not reach statistical significance (p=.12); (4) Conclusion: This study provides normative SWE values for the patella and achilles tendon using the Samsung RS85. These values can be used for comparison to pathological tissue by means of the same examination protocol to better understand tendon degeneration. Further studies are warranted as to how SWE can be applied to the diagnosis of tendinopathy, partial and full-thickness tears, and response to treatment.

The COVID-19 pandemic has caused unprecedented challenges in the care of children with cerebral palsy (CP) and other neuromuscular complex chronic conditions (NCCC). The purpose of this study was to explore the direct impact of the COVID-19 pandemic on healthcare delivery. From May to August 2020, medical professionals caring for CP and NCCC patients across multiple countries and disciplines completed a self-administered cross-sectional survey comparing practices before and during the COVID-19 pandemic. Of the 79 healthcare workers from 8 countries who participated—predominantly pediatric orthopedic surgeons (32%), pediatricians (30%), and pediatric physiatrists (23%)—most felt that caring for NCCC patients during the pandemic presented with unique difficulties and reported a significant decrease in in-person NCCC clinic volume (p<0.001), multidisciplinary appointments (p<0.001), surgical cases (p=0.005), and botulinum toxin/phenol injections. Most providers affirmed that institutional guidelines for perioperative emergent/urgent and elective procedures, workplace settings, and technology were modified to accommodate the ongoing public health crisis. Usage of telemedicine significantly increased for NCCC patient visits (p<0.001). During the COVID-19 pandemic, many children with NCCC lost access to routine, multidisciplinary care. Telemedicine became an integral part of communication and management. In the setting of the COVID-19 pandemic and threat of future healthcare disruptions, these data lay the foundation for trending the evolution of healthcare delivery and accelerating best practice guidelines for children with CP and NCCC.

Musculoskeletal disorders are increasingly prevalent worldwide, causing significant socioeconomic burdens and diminished quality of life. Notably, patellar chondropathy (PC) is among the most widespread conditions affecting the joint structures, resulting in profound pain and disability. Hyaluronic acid (HA) and platelet-rich plasma (PRP) have emerged as reliable, effective, and minimally invasive alternatives. Continuous research spanning from laboratory settings to clinical applications demonstrate the numerous advantages of both products. These encompass lubrication, anti-inflammation, and stimulation of cellular behaviors linked to proliferation, differentiation, migration, and the release of essential growth factors. Cumulatively, these benefits support the rejuvenation of bone and cartilaginous tissues, which are otherwise compromised due to the prevailing degenerative and inflammatory responses characteristic of tissue damage. While existing literature delves into the physical, mechanical, and biological facets of these products, as well as their commercial variants and distinct clinical uses, there is limited discussion on their interconnected roles. We explore basic science concepts, product variations, and clinical strategies. This comprehensive examination provides physicians with an alternative insight into the pathophysiology of PC as well as biological mechanisms stimulated by both HA and PRP that contribute to tissue restoration.